Bulletin of the World Health Organization – Volume 95, Number 1, January 2017, 1-84

Bulletin of the World Health Organization
Volume 95, Number 1, January 2017, 1-84

Documenting attacks on health workers and facilities in armed conflicts
Preeti Patel, Fawzia Gibson-Fall, Richard Sullivan & Rachel Irwin
[Initial text]
During armed conflicts, international humanitarian law (which regulates the conduct of parties engaged in war) protects health-care workers and health facilities, the wounded and the sick. In the first half of 2016, however, the international medical charity Médecins Sans Frontières (MSF) reported several attacks on health facilities and workers in Afghanistan, the Central African Republic, South Sudan, the Syrian Arab Republic and Yemen.1 These events have attracted media attention to a phenomenon of contemporary armed conflict that has important ramifications for the health, humanitarian, legal and security sectors.2 In December 2015, the Stockholm Peace Research Institute and the Conflict and Health Research Group at King’s College London convened a workshop in London on Eliminating violence against health workers: from theory to practice. Participants from MSF, the International Committee of the Red Cross (ICRC), Medical Aid for Palestinians and academic organizations discussed current trends in violence against health workers and attacks on health facilities, presented research findings and highlighted key debates and research gaps in evidence.
Some important lessons can be drawn from ICRC’s Health Care in Danger campaign, MSF’s Medical Care Under Fire campaign, as well as other organizations such as Physicians for Human Rights, which has recently documented mass atrocities in the Syrian Arab Republic as well as the impact of the Syrian conflict on the health sector.3–5 There is a perception of an increase in the number of health workers being killed and facilities being accidentally destroyed (so-called collateral damage) or deliberated targeted during armed conflicts. Comprehensive databases have been set up by independent research organizations to record major incidents of violence against aid workers, such as the Aid Worker Security Database of Humanitarian Outcomes and the Security in Numbers Database from Insecurity Insight.6 However, even these do not currently provide health-specific data. The absence of baseline and routine data relating to attacks on health workers and health facilities makes it difficult to identify actual rising trends. Most of the available data sources do not capture violence on local health workers, who seem to bear the brunt of most attacks. Data disaggregated by sex are also lacking…6